On June 2, Apple announced a new health and wellness platform that would live natively in the upcoming iOS 8 release. At this point, what that translates into is a pair of apps, Health and HealthKit, that will work in tandem to monitor an iPhone user’s health statistics.
On the surface, that doesn’t sound like a huge deal; there are already plenty of fitness trackers. But this is Apple, the company that got much of the world to carry tiny computers around in their pockets by calling the thing “a phone.”
Furthermore, this could be, as some experts speculate, one of the necessary dominoes Apple needed to fall before it could introduce wearable technology, what some are calling an “iWatch” until Apple introduces a better name. This could be the company’s big competitor to Google’s Glass and further compel many of us to integrate computers even more deeply into our everyday lives.
And we haven’t even yet discussed what this will mean for your own health. With all this data, conversations with your family physician will sound very different in about five years.
With such big consequences in play, a number of experts have offered insights and analyses. Here are 25 such experts from academia, the medical world and tech journalism weighing in on just how impactful Apple’s new health platform could be.
Comments from Doctors
The HealthKit API breaks very exciting ground. For a subspecialty like cardiac, we’re monitored on what our 30-day readmission rates are. [This gives us] the ability to have the patient monitored at home with a variety of devices and move the information into the data aggregator, HealthKit. Our doctors can pull the vital numbers they need into the electronic medical record as a permanent catalog, and intervene if they need to. We can keep patients at home or pull them back into the hospital if we need to interact with them sooner.
Apple has built one hell of a tracker.
But tracking is not enough to make us healthier. Although no formal studies have yet been published, researchers aren’t hesitant to share their suspicions that health benefits of trackers are short-lived. Users may experience a quick boost from their Fuelband, FitBit, or Jawbone UP, but results soon plateau and they’re left feeling frustrated.
If Health is to avoid the same embarrassing fate as Maps, Game Center and other notable iOS flops, Apple needs to build more than a just a tracker. To make it a true success, Health needs to help users live healthier lives, not just display beautiful data.
It will be really important for companies to justify their interpretations of the information they provide to achieve physician buy in. Otherwise, these consumer-focused devices will be written off as health toys rather than health tools.
Physicians have the ability to empower patients like never before.
I prescribe health apps to my patients all the time in the ER. Many of the health apps I prescribe are related to weight loss. I encourage patients to download pedometer apps, especially to iPhone 5s users due its M7 activity sensor.
Usually, I have to show patients how to use the app, and I’m no longer surprised when they don’t even know how to download new apps to their phone — but understand how to use the email and texting capabilities of their phones. Because the health app is a native app, you are assured a patient with an iPhone (running iOS 8) will have the ability to track key health metrics. You can use this ability to empower the patient to be a co-manager in their disease pathology, and give them more ownership of their health.
Like Samsung, Apple is building a platform rather than a complete health solution. Much as with its new home automation platform, Apple isn’t trying to build an overarching Apple solution so much as its providing developers and hardware makers with a way for their new and existing products to exchange data.
That exchange appears to function in both directions. Apps or devices designed to track metrics can feed data into the Health app and the HealthKit APIs also allow it to send data to other apps — that means disparate tools can work in tandem.
Way before there was any hype about a Healthbook or HealthKit from Apple there was a patent application that we covered back in 2010 concerning a future iPhone with a seamlessly embedded heart rate monitor titled “Apple Takes a Giant Leap in Biometrics with Heart Sensors.” This was one of the first indicators that Apple was exploring next generation sensors for the iPhone and other future wearables such Apple’s EarPods which this patent covered specifically.
[On June 19], the US Patent and Trademark Office revealed that Apple has tweaked the very patent that we covered in 2010 under application 20140171776. Apple has reduced the number of patent claims and may have tweaked other areas that we just couldn’t identify under time constraints.
In Apple’s patent we discover that future iterations of the iPhone could very well support sophisticated embedded heart sensors to monitor the user’s heart and record such data for future identification purposes when making banking transactions or protecting highly sensitive documents or data.
Google, Yahoo and others gather correlate, analyze and use personal identity metadata including your location, search history, browsing history to monetarize for their own purposes or to sell to others. I believe Apple is trying to build a counter story on security using identity and services encapsulated in devices you own.
Apple provides fine-grain control to developers when it comes to permissions, as well. This lets a user choose, very explicitly, the kinds of data that an app will share with Health. But it also offers specific, separate, permissions for reading and writing data. This means that you could choose to let an app send data to Health, but not read other types of data you don’t want it to see. And even the ‘read/write’ status of a particular type of data is masked from third-party apps, so that they don’t know what you don’t want them to know.
Given that health data is so sensitive, the extra attention to permissions detail is certainly welcome.
We carefully protect (patient) privacy so (the patient) can have total control over which applications have access to which part of (their) healthcare information.
The problem with Federighi’s promise is that consumers need to approve data-sharing from as many apps as possible to gain the promised comprehensive medical view. Also, consumers have no way to know the relative security levels of various apps. The better approach is to allow providers like Mayo to make those distinctions and to decide which apps can and cannot access parts of their data.
The Health and Fitness Apps Market
Health and fitness app usage has climbed significantly faster than mobile app usage overall, which has increased by 33% in the last six months. That was a turnaround from 2013, when total daily app usage increased by 115% but the health and fitness category grew by only 49%.
— Simon Khalaf, CEO of mobile analytics/optimization firm Flurry, as reported by Gregg Keizer [source: ComputerWorld.com]
An estimated 40 percent of Americans already have medical information digitally stored on an Epic Systems health record. And Apple’s new HealthKit will integrate with those millions of patient records, the company announced Monday.
Research firm IHS Technology recently predicted that global sales of sports, fitness and activity-tracking devices will grow from $2.2 billion in 2014 to $2.8 billion in 2019, with the number of gadgets in use rising from 84 million in 2013 to 120 million by 2019.
Apple is making a big move — their first really big move in healthcare that I’m aware of. Still, a lot of us were expecting a bigger move — an integrated hardware / software announcement.
Apple is promising new products later this year and Health and HealthKit potentially pave the way for Apple’s own entry into the smartwatch market — some kind of iWatch has been rumoured for years now.
Apple Health and HealthKit gives Apple a way of making sure its rivals don’t get too far ahead in the consumer fitness and wearables market but also potentially opens up a new and much bigger serious healthcare element too.
Apple has spent the better part of the last few months hiring health experts, like J.E.M. Raymann, a sleep researcher from Philips Research who specializes in sensors. The evidence seems to point at a long rumored iWatch in the making in the future, which likely will differentiate itself from other smartwatches with a focus on health tracking.
It’s likely Apple will have an even greater advantage over WebMD and its other competitors if the company releases an iWatch this fall that pairs with the Health app. Apple has obviously been very successful pairing its own software with its devices, and an iWatch working in tandem with the Health app could prove to be too much for Healthy Target and other apps like it.
Even if people don’t opt for an iWatch and instead use other wearables to send data to the Health app, Apple will still have the advantage of giving users the option to send their data directly to doctors. As technology becomes more integrated with health, this factor will become more important than ever.
If Apple curates its developer community well, we could be seeing a new cottage industry of effortless health apps that make improving daily life as easy as checking the weather when we wake up.
The numbers and units that Apple used as examples to illustrate their vision don’t make sense. When you measure your glucose with a personal blood sugar meter, it is measured in mg/dL— but the example shown by Apple displayed these numbers in mL/dL. Whoops!
What’s worse, the app screen features an SMS-style message from a particularly photogenic doctor who says, ‘You’re making great progress with your diet and exercise. Keep it up.’ While the graph above this message shows a steady and very unhealthy looking uptrend in the users glucose readings. The current reading shown on the app is 122 ‘mL/dL.’
‘People with a fasting glucose level of 100 to 125 mg/dL have impaired fasting glucose (IFG), or prediabetes,’ according to a National Institute of Diabetes and Digestive and Kidney Diseases website. ‘A level of 126 mg/dL or above, confirmed by repeating the test on another day, means a person has diabetes.’
In place of a two-sided market Apple is proposing to coordinate a multiparty market that will include hospitals, insurers, family doctors, labs, devices, monitoring services, analytics and users. That makes the market more ecosystem-like and poses new degrees of complexity on designing the proposition, marketing it and coordinating multiple counter-parties.
Just weeks after Apple announced its Health app for iOS 8 and corresponding HealthKit platform for allowing developers and accessory manufacturers to tie into the system, Google will apparently be making a similar announcement at its Google I/O conference. According to Forbes, Google’s new Google Fit service will perform a similar function to HealthKit, aggregating data from fitness trackers and apps in one place on the user’s device.
[P]eople are more important than technology. This is a key point. Real change happens when people change their behavior, not when new technology appears.
No doctor, no matter how dedicated, wants to know every glucose value of every patient every day, or each patient’s daily weight or blood pressure measurement. Physicians barely have enough time to get their work done as it is. None of them could survive this information overload.
Sometimes these individual data points aren’t even important, but when they are — for example, blood-sugar readings for diabetics — physicians might worry about being held liable for missing an abnormal reading. More than a third of physicians have reported personally missing test results that led to care delays for their patients because they are already overwhelmed by alerts and data.
How does Apple Health actually work? Apple provided virtually no details. Does the patient need the Epic MyChart app on their phone? Is there custom code integrating iOS to Epic MyChart? Is there a Mayo Clinic app that is separate from Epic MyChart? If not, how does Apple Health know that the consumer is a Mayo patient? Or a Kaiser Permanente patient? Or a Sutter Health patient?
While the Health app does include a card for medication, it is incredibly underdeveloped. This section of Health app really tips Apple’s hand – this beta version of iOS8 appears to include a very much unfinished Apple Health app.
People are underestimating how big of an impact this will have on healthcare.
US Patent Office